Parents have recently been out of breath with lots of questions regarding the effect of secondhand smoke on their infants and children. So this week let me cough-up, or out, some information on this important topic.

Secondhand smoke or environmental tobacco smoke comes from the end of tobacco products as well as what is exhaled by smokers. In the U.S., sixty percent of 3 to 11 year olds are exposed to secondhand smoke. Why is this a problem? Because this smoke contains more than 4,000 chemicals, more than 50 of which are cancer-causing agents for both adult and childhood cancers. Even after someone who has been smoking leaves the room, the smoke remains and settles on surfaces throughout the building. Speaking of buildings, a recent study showed that children who live in multi-unit housing carry a 45% increased risk of showing the complications of secondhand smoke even if no one in the immediate home or apartment smokes.

In children, cancer is not the only problem. The chemicals in secondhand smoke can inflame and injure their lungs resulting in 25,000 new cases of asthma a year in this country. It worsens the condition of as many as 1 million asthmatic children and causes 150,000 - 300,000 new cases of pneumonia, many of which require hospitalization. It has even been associated with an increased risk of sudden infant death syndrome (SIDS) and heart disease as children exposed to second hand smoke age. Even the frequency of colds, coughs, sleep disorders, or ear infections can increase due to secondhand smoke with at least one-third of ear infections being attributable to passive smoking.

If you are pregnant and exposed to secondhand smoke, studies suggest an increased risk of miscarriage, as well as premature birth, sudden infant death syndrome (SIDS), learning problems and attention deficit hyperactivity disorder in your baby after he or she is born.

So, what can you do?

If you smoke, do whatever you can to not smoke in your home.

If you must smoke in the home, limit the smoking to rooms where windows can be left open and/or fans used to move the smoke outside, and don?t let your children use that room.

Don?t smoke in your car even when children are not with you since the chemicals from smoke stay in the air in your car even after you are done smoking.

Make sure your child?s day care, school, and after school programs are smoke free.

Of course, if you or a friend wants to stop smoking that is the best solution. Help is available by calling the Vermont Quitline at 1-800-QUITNOW, or in New York, call 1-800- NYQUITS. The American Lung Association at 1-800- Lung-USA can also help you break this unhealthy habit.

Hopefully, tips like these - and we?re not talking filter tips - will smoke out why it is important for you to recognize the importance of protecting your child from secondhand smoke.

Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at http://www.FletcherAllen.org/firstwithkids